Suggest dosage for Methadone while treating stenosis and osteoarthritis

Posted on Fri, 29 May 2015

Question: Methadone is THE ONLY drug that handles my stenosis and osteoarthritis. I have been on it for 5 yrs. Dr had me up to 200mg/day at one point which, I admit, was too much. However lately the Drs around here are terrified of the newer FDA reports and want nothing to do with it. My GP lowered me to 30 mg/day and this IS INSUFFICIENT. He actually handed me off to a pain center that is 40 miles away and I can't drive due to eye problems. This is VERY hard on my wife and her job. The pain center pushed suboxone but, after much consideration and research, I decided against it. Suboxone apparently does nothing for the pain that is the root of the problem! I can usually be fine on 60mg/day but weather related breakthrough pain requires more maybe 3 or 4 days /month average. My Drs won't allow me to live my life. Anyone have any suggestions?

Answered by Dr. Swarnava Dattagupta (6 hours later)

Brief Answer:
Methadone at 60-80mg/day can be taken; get LFT done

Detailed Answer:
Hello.

This is Dr. Swarnava Dattagupta answering your query.

I understand your query. Methadone is an opioid and has some mild addiction potential. So those who get pain relief with it tend to continue it. If you have been on methadone for 5 years without troubles, then I feel you can be continued with a maintenance dose which is 60-100mg/day in divided doses. In your case perhaps 60mg is an OK dose. However there should be renal and hepatic monitoring and dose adjustments. Discuss about it when you next visit the pain specialist. If both are fine, its okay. Otherwise, dose reduction has to be done.

Hope this was useful. If you have any other questions, i would be happy to help.

Regards

Above answer was peer-reviewed by : Dr. Prasad